Credentialing for Durable Medical Equipment Supplies

Provider credentialing is a popular term among those who want to start their own durable medical equipment (DME) billing business. Starting a DME billing business is not as easy as you see it. Like other businesses, DME billing also incurs a lot of groundwork and neat establishment. But one good thing with this business is unless you get everything right, you may not be able to start with. So in the future, you need not break your head with any complexities involved in the business.

In today’s scenario, the biggest challenge that you may face with DME billing is collecting payments from your clients /patients. Due to the number of companies offering insurance with a wide range of benefits to their employees, it becomes a hard task for DME billing companies to deal with. But, even success also lies in the same factor. Therefore, you will likely be handling the burden of accepting the insurance, billing the insurance company, and receiving funds from the insurance company on time.

Let us take a deeper look into the credentialing process for DME billing.

How and whom to approach for DME billing credentialing?

Finding the best insurance company to network with is a long and tough task as well. Sticking onto one big insurance company does not work well for running your business. You should tie up with both private and public companies of various types and allow patients to use their insurance card with you. You should also understand the fact that choosing the best insurance companies for your DME medical billing company takes a good time.

You can see certain small insurance companies that have more employees, which yields great profitability to your company. You should consider such companies as well. Therefore, the list of insurance companies you collaborate with should be a combination of all three to engage more patients using your facility for consultation and medication.

What is the process of obtaining DME Billing credentialing?

• First, you need an office space for establishing your business.
• Open a bank account for your business.
• Acquire a business name for your organization and a stabilized location.
• Now you require licensing information, background, portfolio, website, company safety insurance. Make sure that you have the application signed and legally documented and obtain a unique Federal Tax ID#.

The approval/denial of DME billing provider credentialing takes at least 90 to 120 business days for 8–12 carriers. After which you continue with contracting which shows your eligibility criteria for networking with insurance providers. You receive a contact form to be duly signed by you and sent back to the insurance company, and in the next 30-60 days, your contract gets confirmed. Remember that it is not a wise idea to acquire networking with an insurance provider after you establish your company and run the business as usual.

How to begin with the credentialing process?

Instead of getting involved by yourself in the credentialing process, hire specialists who can take your burden on their heads. Leave the entire process to them right from acquiring the insurance partner, application form filling, and follow-up with insurance companies and focus on your potential customers. There are many agencies available for handling the same. First select companies that are mostly within your proximity or in main areas of the city and get quotations from the shortlisted ones. Finally, choose the one you are comfortable with.

Conclusion:

24/7 Medical Billing Services is one such company that has met all the aforementioned expectations and gained expertise over time. The process was initially so crucial because you will be in an urge to establish your DME billing company. But rather than just establishment, you should think over the stability and facility that customers expect from your end. The secondary aspect of your focus should be on hiring a team that can work without compromising on quality and service, whereas the first comes to the insurance provider.

Be sure about your needs and what could make you successful before you begin with. Definitely, it will help you gain popularity and potential customers, vendors, or suppliers as a betterment. 24/7 MBS is successful because of not only their quality of service but also staying in line with the latest trend and wish to be up-to-date in every stage.

About 24/7 Medical Billing Services

24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%.

Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.

 

Media Contact:

Hari Sudan, Media Relations,

24/7 Medical Billing Services,

16192 Coastal Hwy,

Lewes, DE – 19958

Tel: + 1 -888-502-0537

Email - info@247medicalbillingservices.com

Website – www.247medicalbillingservices.com

Top Reasons for Revenue Leakages in Durable Medical Equipment (DME) Billing

Revenue leakages are a major concern in the healthcare industry. They are the difference in the claimed amount that healthcare providers are entitled to receive versus the amount of the reimbursement they actually receive. This phenomenon is especially common in the Durable Medical Equipment (DME) billing & coding industry because of the inherent cumbersome nature of DME billing.

●     As per the Harvard Business Review, the top hospitals have lost hundreds of millions of dollars of income due to revenue leakages 

●     As per American Hospital Association, all kinds of U.S. hospitals reported approximately $620 billion in uncompensated care costs since 2000. 

 

Top reasons why revenue leakages happen in DME billing and coding:

• Denial of claims: 20% of all revenue loss is due to denial of claims. Claims can majorly be denied if:

1. Demographic Information of the patient is incomplete.
2. Information is missing or invalid.
3. Medical Necessity of DME usage is not clearly mentioned.
4. CPT code, Modifier, PIN, or NPI is incorrect or missing.
5. Duplicate claim or service is found.

 

• Inaccurate codes: Another common reason for revenue leakage is incorrect coding of accessories or equipment. Only when the DME biller identifies the right HCPCS level II codes and sends over the claim with authorization paperwork, the insurance company will pay the claim.

• Non-compliance: All the guidelines laid down by the Health Insurance Portability and Accountability Act (HIPAA) and the Office of the Inspector General (OIG) must be followed to the last bit in order to prevent complete rejection of your claims and thereby leakages in revenue.

• Lack of real-time monitoring: There’s no substitute to correct and real-time data. If that’s not available and there are discrepancies in your data, be sure of major revenue leakages. Why? Because without real-time data, decisions will not be backed up by accurate data. For example, if the insurance policy does not cover a specific treatment, this can be communicated to the patient and the provider beforehand so that there are no issues in the DME billing.

• Incorrect data: Inaccurate data entry in the database can give rise to mismanagement of funds and thereby revenue leakage. Until the data is meticulously collected and analyzed by experts, error-free billing is a distant dream.

• Failure to Follow-up: Failure to follow-up regularly can sometimes lead to non-payment of claims. If there’s a delay or the claims are outrightly rejected, DME billers need to follow up or resubmit the claims to avoid revenue leakage.

• Lack of expert guidance: By now you know that DME billing is an exhaustive process and must not be handled without expert guidance. Revenue leakages mainly happen when non-professionals venture into it and do not adopt DME billing outsourcing. Billing professionals can help you avoid errors, identify loopholes, get payments on time, manage denials and rejections of claims, and streamline the entire billing process so that you receive the payments you deserve.

 

The first step to avoid all forms of revenue leakage in DME billing and coding is to identify the loopholes. By giving the process in the hands of experts, you ensure that you’re focusing on what you’re best at - treating patients, which by the way will lead to revenue generation in the long run.

 

About 24/7 Medical Billing Services

24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%.

Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.

 

Media Contact:

Hari Sudan, Media Relations,

24/7 Medical Billing Services,

16192 Coastal Hwy,

Lewes, DE – 19958

Tel: + 1 -888-502-0537

Email - info@247medicalbillingservices.com

Website – www.247medicalbillingservices.com

Medicare Procedures for DMEPOS

Medicare is an insurance program, offered by the federal social committee and popular among DME billing companies and customers as well. It focuses primarily on older and disabled people. Medicare holds a share of 21% in terms of U.S healthcare expenses and 17.8% of Americans based out of the U.S have been covered by Medicare. Therefore, most of the DME billing companies first prefer enrolling in insurance programs offered by Medicare.

If you are a new DMEPOS supplier, you should definitely register your business with the Medicare enrollment application to become qualified to get paid for insured customers through Medicare. This blog takes you through the complete Medicare procedures for DME billing and how it is effective as well.

The application form provided by Medicare requires you to fill in all the information about you and secures only the needed documentation. This cross check’s your eligibility criteria before you apply for DMEPOS with Medicare and then allows you to enroll in the program.

How to enroll in Medicare?

The Medicare enrollment process is very simple and quick as well.

• First, the National Supplier Clearinghouse (NSC) initiates and progresses your enrollment application and proceeds with the verification of your information.
• In case NSC asks for more information in the due course, you should be in a position to provide the same.
• You should respond to the mail requests sent by NSC immediately; showing a delay in response can lead to further delay in your enrollment.

Enrollment process

The following procedure is for becoming a DMEPOS (Durable medical equipment, Prosthetics, Orthotics, and Supplies) supplier.

Step 1: The applicant fills and submits the Medicare enrollment application form and the respective documents to the NSC.

Step 2: The NSC validates the application and carries out a site visit to ensure and mark compliance with all DMEPOS supplier standards.

Step 3: Once the verification is complete, the NSC informs the applicant through mails about the status of their decision towards the applicant’s enrollment application.

If you have any information to be changed in the Medicare enrollment application form, you should inform the NSC within 30 days of applying. You do not have to grab a new enrollment form; instead, you can make use of your existing application form and mention, highlight the changes alone.

Before we get close to the final step in the Medicare program enrollment procedure, you must know about the term Participation. Participation is more or less similar to accepting assignment of claims every time for all services you offer to beneficiaries of Medicare. It also ensures that you collect payments as one-time and do not claim other than Medicare deductible or coinsurance of the beneficiary if any. Though you agree to the point of participation or not, according to the Social Security Act, Medicare expects you to submit claims for its beneficiaries without fail.

The participation benefits you in several ways. As a DMEPOS supplier, you receive the payments directly from Medicare because they are all assigned. The claim information is transferred to Medigap insurers i.e. for medical supplemental coverage.

Medicare enrollment and registration

The standard healthcare transactions in recent times are controlled by the National Provider Identifier (NPI) over the healthcare provider identifiers. So it becomes an unleveraged rule for DMEPOS suppliers to acquire the NPI before they intend to enroll in Medicare programs. Only if you do this, you will be able to bill and be paid for services offered to Medicare beneficiaries.

Conclusion:

24/7 Medical Billing Services is one such company that tops when it comes to DME billing and coding, helping independent doctors, nursing homes, hospitals across the United States, by handling their medical billing effortlessly and efficiently. The best part with 24/7 is they are experts in Credentialing, A/R Follow up and denial management services across the nation.

About 24/7 Medical Billing Services

24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%.

Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.

Media Contact:

Hari Sudan, Media Relations,

24/7 Medical Billing Services,

16192 Coastal Hwy,

Lewes, DE – 19958

Tel: + 1 -888-502-0537

Email - info@247medicalbillingservices.com

Website – www.247medicalbillingservices.com

Durable Medical Equipment (DME) Billing at just 8 USD per hour - 24/7 Medical Billing Services

The increasing growth rate of the aged population is one of the major reason for the surge in DME billing. The advanced medical technology, the increasing rate of chronic diseases is a key factor for the expansion of the Durable Medical Equipment (DME) Billing market across the globe. Aged individuals are more prone and susceptible to health disorders and problems such as heart diseases, diabetes, kidney failure, arthritis, and many others. This has resulted in the creation of a separate market for various DME products and equipment such as crutches, walkers, wheelchairs, traction and trapeze equipment, hospital beds, oxygen and respiratory equipment, patient lifts, infusion equipment and supplies and several others.

Durable Medical Equipment (DME) billing is quite different and unique from medical billing and other coding procedures. DME billing is a highly complicated and intricate process. It requires extensive, in-depth, and robust knowledge about the DME process, industry mandates, and all the HCPCS level II codes. All Durable Medical Equipment and products are categorized under the HCPCS level II codes. Since expensive medical equipment needs to be purchased, DME billing and coding specialists need to be aware of how to code claims accurately and the timing of claims submission to get the proper reimbursements.

DME billing and coding process

• Medical practitioner prescribes the necessary medical equipment for the patient.
• Documentation of the patient information and key details.
• Preparation of documents for claims submission citing the reasons why the medical equipment is prescribed to the patient.
• Stringent eligibility check and pre authorization to find out whether the patient is applicable. 
• Required permission from the insurer is initiated.
• Initiation of the coding process. This involves identifying the correct HCPCS Level II codes from the HCPCS manual.
• Stringent checks are performed to ensure that every accessory and part of the equipment is correctly coded.
• Once the coding stage is completed, the DME billing company files the claim along with the necessary paperwork to ensure that the insurance company pays the right amount to the healthcare service provider.

• Frequent follow-up on the claims by the DME billing company.

Challenges and problems in DME billing and coding

DME billing and coding can become highly challenging and demanding if you don't have skilled and experienced billers and coders. There are several complexities and challenges associated with DME billing. Some of these include gathering and compilation of proper patient data, patient validation, obtaining authorizations, use of the correct forms for claim submission, and HIPPA compliance.

1) Use of redundant and obsolete software

Lack of proper knowledge about the latest DME billing software and use of old backdated software results in unsuccessful billing.

2) Lack of proper documentation

The DME billing process is quite tedious and exhaustive. This is why many billers miss on minute details in the documentation resulting in claim denials.

3) Incompetent resources

Most healthcare providers hire limited DME billers and coders since it is extremely extensive to have a huge team onboard. Working with limited team strength will increase the burden and workload on them. Too much pressure and limited time affects their productivity and efficiency as well, which may lead to errors in the DME billing process.

Outsourcing - An effective way to come out of all DME billing challenges

With the increasing demand and rising salaries of DME billers and coders, the majority of healthcare practices are opting for outsourcing their Durable Medical Equipment billing requirements. This is because outsourcing is not just a convenient option for them but a cost effective one too.

24/7 Medical Billing Services - Simplifying DME billing complexities for you

24/7 MBS is a popular name in the DME coding and billing industry across the globe. We have onboard a highly skilled and experienced team of coding and billing professionals who have in-depth technical knowledge and expertise in DME documentation requirements. They always remain updated regarding any major changes happening in the DME billing industry. 

Our team would handle everything associated with DME billing and coding from start to end - from identifying cases that are eligible for reimbursements, claim documentation, and timely submission.

Whether you are a well-known healthcare center or an independent medical practitioner, our tailor-made DME billing services are set up as per your requirements. We understand that the requirements of each healthcare provider is different, hence we do not follow a one size fits all approach.

Partnering with us will enable you to streamline your billing process. You can rely on us to prepare claims with accurate codes and submit them to the relevant insurance authorities to get timely reimbursements.

Being one of the leading providers of DME billing services, we have assisted several independent physicians, hospitals, and nursing homes across the country and worldwide in increasing their revenue generation from claims.

In order to help DME billers and coders, 24/7 MBS has produced several helpful educational videos on effective billing and coding tips. 

The main objective behind our DME billing and coding services is to reduce the workload and pressure on physicians and medical practitioners. Our services empower them to focus on what they are best at doing, i.e. taking care of their patients. In order to extend the benefits of our services to everyone, we have recently introduced DME billing on an hourly basis, at just 8 US dollars per hour" says Harry, CEO, 24/7 Medical Billing Services.

DME billing services at just USD 8 per hour - A new initiative by 24/7 MBS

In an attempt to simplify things for medical practitioners and healthcare centers, 24/7 MBS is offering DME billing and coding services at just $ 8 per hour. 

"Any medical service provider can reduce their AR in just $ 8 per hour. This is a one of a kind initiative launched by us and is strictly a limited period offer. The reason behind launching this scheme is to cater to the needs of startups and independent medical practitioners within a limited budget. This special initiative is aimed at giving you the highest collection rates and reducing your AR bucket by a significant margin. " says Ken Staten, Sales Director at 24/7 MBS.

Ken elaborated further, " If you choose us as your medical billing partner and sign up for the limited period offer, we would be providing free credentialing -services as a part of the extended service agreement. We specialize in medical credentialing and have already credentialed thousands on the insurance panels. We'd love to credential you too!"

Distinctly different medical billing services from 24/7 MBS

Are you a startup healthcare center or a new medical practitioner? Are you looking out for outsourcing your DME billing work to a company who has expertise in Brightree, BFLOW, and Advanced MD. Our unique and different $ 8 dollars per hour billing services can provide you with a plethora of benefits.

1) Eliminates the chances of billing and coding errors

Being experts in the coding industry, we perform constant stringent quality checks which nullifies the chances of any errors in the DME billing process. This is something which your in-house experts won't be able to do easily.

2) Saves valuable cost and time

Outsourcing your DME billing work to us helps you to reduce your operational costs by a significant margin. Moreover, you can focus on your patients rather than spending unnecessary time overlooking the billing process.

3) High collection rates

Our DME billing services help you achieve the highest collection rates and reduce your AR bucket by a great number at just $ 8 per hour.

About 24/7 Medical Billing Services

24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%. Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.

Media Contact –

Hari Sudan, Media Relations,

24/7 Medical Billing Services,

16192 Coastal Hwy,

Lewes, DE – 19958

Tel: + 1 -888-502-0537

Email - info@247medicalbillingservices.com

Website – www.247medicalbillingservices.com

Setting up a DME Store – Here’s a Checklist you should be aware of

It is natural that people get sick and approach healthcare centers for treatment/consultation irrespective of the state of the economy. This is one of the reasons that make hospitals and healthcare-related businesses stay away from recession. Due to the increase in the need for healthcare services among the public, we see a rise in the number of healthcare and related facilities as well. But what drives these facilities to be successful are essential medical supplies in surplus, which has been a motivational factor for starting a DME store.

Especially, during this pandemic, people definitely look out for healthcare centres/stores which offer great benefits. Therefore, you cannot find a better time to set up your DME store than considering the current scenario. Giant companies already exist in the market supplying a huge amount of medical supplies to healthcare facilities; yet, there is a large scope for independent DME stores to establish their business as well.

Before you implement your idea of setting up a DME store, it is ideal that you know whether there is a need for the same in your place. Otherwise, your business will be listed just as another business if not serving any demand.

Why go for a medical supply business?

Starting your own business is a great idea because you can be your own boss, and it creates financial freedom as you expect. DME supply is an ever-growing and on-demand business, which can yield you profits for the money and time you invest in.

You can create a brand image for your business by specializing in a certain line of products. Opening a DME store is a cost-effective way to enter the medical field that allows you to develop in no time. To develop a successful DME medical supply business, all you require is proper research in the background. You should be fully aware of the loopholes and look for opportunities in every gap since the industry is large.

You can opt for both in-store and online DME medical supply business and reach your customers anytime.

What factors should be considered for setting up a DME store?

To start your ideal DME supplies store, here are certain criteria you can follow:

#1: Think of which best method can help you operate your DME medical supply business. You can open a physical store, make it available on your own ecommerce website, sell it on any e-commerce platform that accepts medical supplies, or combination of both.

#2: For opening a physical DME store, you require a perfect location. In case you prefer to go for an online business, you can operate the business from your home. You can rent or lease a commercial property that suits your business requirements.

#3: Now you should look at the possible markets you can bring into your DME business. Some of it includes durable medical equipment, dedicated equipment that provides continuous positive airway pressure and several respiratory equipment, etc. You can choose your own niche and enter the DME supply market.

#4: Hunt down potential office locations near doctor's clinics, hospitals, and similar ones. Only when you are exposed to medical providers, you get patients through the reference.

#5: Acquire a business license from your local city so you can manage anything within your proximity.

#6: Liberalise the personal needs of your DME office.  Work out the best market plan that serves your business needs in terms of hiring talented resources across verticals such as equipment repair and maintenance, walkers, wheelchairs, hospital beds, and wheelchairs that function using the battery.

#7: Get a few people at the reception who can handle multitasking that improves your customer satisfaction, and at the same time, engage more customers based on responses you provide them.

5 Best keys for showing development in your DME supply store

You should try implementing the following 5 attributes to develop DME business in your pharmaceutical store, explicitly.

#1: More appearance more attention

Make your products more visible to customers who walk-in to your store. This helps you with the maximum reach of your store products.

#2: Engage well-trained staff

Appointing dedicated and well-trained staff in the DME Billing section projects your business as an organized one. Likewise, allocate staff to every section based on their potential and skillset. Your staffs remain up-to-date on technologies in this way.

#3: Educate providers

Conduct training sessions/ conferences/seminars for your medical providers and make them understand the challenges you face in DME billing business concerning insurance coverage.

#4: Stay in line with the latest trend

Gain awareness about newly launched products in the market and know what a DME supply business is likely to offer and how to bill for it. You should be able to offer the recommended product based on demand; if so, you can introduce new products.

#5: Maintain a stable cash flow

In the DME supply business, you might face challenges like lower payments, late reimbursements, and frequent audits. Offer a variety of products and keep your customers intact with your store. This ensures that you always have cash inflow in your business.

Conclusion:

There are many things you should take into consideration before you start a DME supply store of your own. The information provided in this blog can guide you through the establishment stages. You will know how to deal with things as in when you move from one stage to another in facilitating your store. 

About 24/7 Medical Billing Services

24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%.

Call us today at 888-502-0537 to know more on how we can help boost profitability for your practice.

Media Contact:

Hari Sudan, Media Relations,

24/7 Medical Billing Services,

16192 Coastal Hwy,

Lewes, DE – 19958

Tel: + 1 -888-502-0537

Email - info@247medicalbillingservices.com

Website – www.247medicalbillingservices.com